WHAT IS HAND THERAPY? Treating more than just a hand… [Insert presenter’s name, date, and location]

Biography [Insert therapist name and credentials] Educational Background Additional Training Years of Experience Points of Interest

Presentation Outline The Hand Therapy Profession The Hand Therapy Profession Commonly Treated Conditions Commonly Treated Conditions Evaluation Techniques Evaluation Techniques Treatment Techniques Treatment Techniques

THE HAND THERAPY PROFESSION

Hand Therapy is… “…the art and science of rehabilitation of the upper quarter of the human body. Hand therapy is a merging of occupational therapy and physical therapy theory and practice that combines comprehensive knowledge of the upper quarter, body function, and activity. Using specialized skills in assessment and treatment, hand therapists promote the goals of prevention of dysfunction, restoration of function, and/or reversal of the progression of pathology in order to enhance participation in life situations for individuals with upper quarter disease or injury.” Source: Hand Therapy Certification Commission (

A Hand Therapist is… An Occupational or Physical Therapist who specializes in the care of upper extremity conditions and injuries including the hand, wrist, elbow, and shoulder Many of these specialists have chosen to pursue the Certified Hand Therapist (CHT) credential

The Certified Hand Therapist (CHT) Has a minimum of 5 years of experience Accumulated 4,000 hours of time practicing and being mentored in the intricacies of the upper extremity Passed a rigorous examination of advanced clinical skills and theory in upper extremity rehabilitation Maintains certification through high quality continuing education courses Source: Hand Therapy Certification Commission (

Hand Therapists have Comprehensive Knowledge of: Anatomy and physiology of the following systems: skin/connective, muscular, skeletal, nervous, vascular, and lymphatic Etiology and pathology of medical conditions Surgical and medical treatment of upper extremity conditions Kinesiology, biomechanics, and pathomechanics Wound and tissue healing Ergonomics and body mechanics Research design and statistics Expected functional outcomes of treatment Expected physiological and psychological effects of treatment

Why Refer to a Hand Therapist? Accurate assessments, immediate care, and effective treatment can reduce overall treatment time Faster recovery results in decreased medical costs Improved functional outcomes ensure a faster return to work and productive lifestyle Client training and education improve compliance and help to reduce recurrence of repetitive injuries

COMMONLY TREATED CONDITIONS Who should be referred to a hand therapist?

What Injuries/Conditions Benefit from Hand Therapy? Tendon and nerve injuries Wounds and infections Soft tissue injuries

What Injuries/Conditions Benefit from Hand Therapy? Fractures, dislocations, and sprains Sports injuries

What Injuries/Conditions Benefit from Hand Therapy? Amputations Burns and frostbite Congenital differences

What Injuries/Conditions Benefit from Hand Therapy? Rheumatoid arthritis and osteoarthritis Dupuytren’s contracture Pain-related disorders

What Injuries/Conditions Benefit from Hand Therapy? Tendonitis such as tennis elbow Cumulative trauma disorders Nerve compressions such as carpal tunnel syndrome and cubital tunnel syndrome

Referrals to Hand Therapy after Surgery Include but are not Limited to: Amputation revision Amputation revision Arthrodesis Arthrodesis Fasciectomy/fasciotomy Fasciectomy/fasciotomy Fracture fixation/bone graft Fracture fixation/bone graft Ganglionectomy's Ganglionectomy's Joint replacements Joint replacements Joint synovectomy Joint synovectomy Ligament repair Ligament repair Nerve decompression Nerve repairs and grafts Neurolysis Replantation Skin grafts and flaps Soft tissue release Tendon repairs and transfers Tenosynovectomy

EVALUATION TECHNIQUES

Range of Motion

Strength Testing

Sensory Testing

Edema Assessment

Pain Assessment

Wound Status

Scar Status

Soft Tissue Status

Functional Dexterity Testing

Functional Assessment

Prevocational Testing

Provocative Testing

TREATMENT TECHNIQUES Meeting your client’s needs

Fostering a Therapeutic Environment

Fostering a Therapeutic Relationship

The Interdisciplinary Approach

Patient Education

Wound Care and Pin Care

Scar Management

Desensitization Techniques

Edema Management

Soft Tissue Mobilization

Motion Restoration Motion Restoration

Functional Dexterity

Functional Activities

Joint Protection and Energy Conservation

Therapeutic Exercise

Work/Sport/ADL Simulation

Work Hardening

Ergonomic Modifications

Electrical Stimulation

Neuromuscular Electrical Stimulation

Iontophoresis

Ultrasound

Heat Modalities

Cold/Heat Modalities

Whirlpool

Customized Orthosis Fabrication Immobilization Mobilization Dynamic Serial Static Static Progressive Restriction Prefabricated Prefabricated w/ custom adjustment

Customized Orthosis Fabrication Immobilization

Customized Orthosis Fabrication Immobilization

Customized Orthosis Fabrication Mobilization Dynamic

Customized Orthosis Fabrication Mobilization Dynamicmic

Customized Orthosis Fabrication Mobilization Static Progressive

Custom Orthosis Fabrication Mobilization Serial Static

Customized Orthosis Fabrication Prefabricated NO adjustment needed

Custom Orthosis Fabrication Prefabricated With expert adjustment

How Do I Find a Hand Therapist? Visit our website:Visit our website:

Questions?

Contact Information [Insert presenter’s name, clinic logo, clinic address, phone # and fax #, and address]

Acknowledgements This presentation was created by volunteer members of the American Society of Hand Therapists’ Public Relations Committee including Sheila Yakobina, OTR/L, CHT, Stephanie Yakobina, OTR/L, CHT, Lauren Hammer, OTR, CHT, Karla Chenault, OTR/L, CHT, Mary Beth Wayne, PT, CHT, Ashim Bakshi, MHS, OTR, CHT, and Cindy Quinnelly, MS, OTR/L, CHT. Special thanks to the many therapists throughout the nation who contributed photos.

References Hunter, JL, et al (eds). Rehabilitation of the hand and upper extremity. 5th ed. St.Louis, Missouri. Mosby, Inc; 2002.Hunter, JL, et al (eds). Rehabilitation of the hand and upper extremity. 5th ed. St.Louis, Missouri. Mosby, Inc; Coppard, BM, et al. Introduction to splinting: a critical-thinking problem-solving approach. St.Louis, Missouri. Mosby, Inc; 1996.Coppard, BM, et al. Introduction to splinting: a critical-thinking problem-solving approach. St.Louis, Missouri. Mosby, Inc; Slide 27 - Aaron, DH, Stegink Jansen, CW. Development of the Functional Dexterity Test (FDT): construction, validity, reliability, and normative data. J Hand Ther. 2003; 16(1): Slide 27 - Aaron, DH, Stegink Jansen, CW. Development of the Functional Dexterity Test (FDT): construction, validity, reliability, and normative data. J Hand Ther. 2003; 16(1): Slide 27 - Jebson, R, et al. An objective and standardized test of hand function. Arch Phys Med Rehabil. 1969; 50: Slide 27 - Jebson, R, et al. An objective and standardized test of hand function. Arch Phys Med Rehabil. 1969; 50:

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